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HEALTHCARE
NEWS
38
Why the No Surprises Act is harming anesthesiologists
By Patsy Newitt
T
he No Surprises Act has created financial challenges for
anesthesiologists, the American Society of Anesthesiologists said
Nov. 15.
e implementation of the law has harmed physicians specifically at
small and medium-sized practices, the society said in a news release.
Insurance companies have slashed payments for anesthesiologists by
nearly 40 percent in many cases.
e ASA proposed a number of changes to the implementation of the
No Surprises Act in a Nov. 14 letter to CMS' Center for Consumer
Information and Insurance Oversight.
Here are three of the changes anesthesiologists are proposing:
1. Audit payer qualifying payment amounts
According to the release, there have been ongoing reports of payers
using inaccurate qualifying payment amounts, including many
unreasonably low rates inconsistent with local in-network contract
rates. ASA proposes CMS implement audits of payer QPAs.
2. Li resolution dispute holds
ere have been numerous reports of independent dispute resolution
holds on anesthesia claims, some in place for 90 days or longer, that
are impacting anesthesiologist practices. e ASA recommends CMS
li these holds and develop guidance that improves the independent
dispute resolution process.
3. Improve batching rules
CMS policy batches anesthesia claims by limiting them to the same
service facility, CPT code and payer, preventing anesthesiologists from
efficiently batching claims. New guidance should align with provider-
payer contracting practices based on an anesthesia conversion factor,
ASA said.
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ADVERTISINGINDEX
Note: Ad page number(s) given in parentheses
Healthmark. healthmark@hmark.com / hmark.com / (800) 521-6224 (pg. 2)
Innomed. info@innomed.net / innomed.net / (800) 548-2362 (pg. 39)
National Medical Billing Services. nationalascbilling.com / (866) 948-8001 (pg. 15)
Stryker. stryker.com/asc (pg. 40)
Zimmer Biomet. zimmerbiomet.com (pg. 3)
